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Common Hip Flexor Injuries and Treatments When Walking






Hip flexor pain when walking? Certainly, it’s not something to be happy about. However, there are many possible things that could be causing this irritation. It could just be a temporary issue – after all, life isn’t necessarily a bed of roses. However, there are times when hip flexor pain is a symptom of an underlying condition that needs to be identified and treated for the sake of your long-term health. There are ways to combat the pain and move forward with your life.

Hip flexor muscles are a set of muscles connected to the hip joint that enable you to raise your knee nearer your chest and bend at the waist. In other words, hip flexor muscles play a critical role in daily movement. When these muscles are damaged, they cause discomfort and impair your ability to function normally.

Injuries may develop in the inner hip muscles, anterior thigh compartment, medial thigh compartment, or gluteal muscles; however, the discomfort associated with an injury is seldom localized. This complicates determining the source of hip discomfort.

This article discusses typical hip flexor injuries and provides information on conservative, at-home treatments for mild to moderate symptoms. Contact a hip expert to get an accurate diagnosis and the most appropriate therapy.

What Are Your Hip Flexors?

Hip Flexors

The hip flexors, also known as the iliopsoas or iliacus muscles, are a group of muscles that help to flex the lumbar spine. These muscles originate on the lateral surface of your femur and insert on either side of your pelvis. Because they are involved in both flexion and abduction, they are often referred to as one muscle.

This muscle group includes three different muscles: iliacus, rectus femoris, and psoas major. The iliacus, the largest of the three, is rectangular in shape and lies on top of rectus femoris; it holds the hip bone (femur) in place and plays a primary role in abduction. The rectus femoris attaches to the interior surface of the iliac crest and is the largest of the three muscles of the hip flexor group. It is more important in extension than in abduction of the hip. The psoas major, also known as the internal oblique, has a lower insertion point on the pelvis and inserts on either side of iliacus; it helps medially rotate (abduct) and laterally rotate (flex) your hips.

The hip flexor group is a group of muscles that help to bring your thighs up toward your torso (hike a football). They also assist in lateral rotation, which brings the knees away from the midline of the body. To understand these motions, visualize a sumo wrestler or football tight end kicking his leg out to the side. The hip flexor muscles are important for achieving good posture and reducing lower back pain in daily life. They are essential for kicking a soccer ball, running, and climbing stairs.

Hip flexor strain symptoms may vary from moderate to severe and might impair your mobility. If you do not take time to relax and get treatment for your hip flexor strain, your symptoms may worsen. However, there are many at-home exercises and treatments that may help alleviate the symptoms of hip flexor strain.

Hip Flexor Strains

Hip Flexor Strains

When the hip flexor muscles are strained or damaged, hip flexor strains develop. Tears are categorized into three severity categories based on their size:

  • Grade I – Mild straining and tiny rips in muscle fibers, resulting in considerable discomfort. The hip is typically functioning.
  • Grade II – Mild straining and tearing of muscle fibers resulting in discomfort. While standing or walking, the hip may sometimes give way.
  • Grade III – Complete tearing or rupture of muscle fibers. The hip is no longer capable of bearing weight.

The majority of the time, a hip sprain starts as a tiny tear that progressively grows in size when the hip is used repetitively. Due to the repetitive usage of the hip in activities such as cycling, jogging, swimming, baseball, and golf, these kinds of injuries are frequent.

Grade I and Grade II strains may be successfully treated with rest and other conservative measures if detected early. Strains of Grade III, on the other hand, are one of the most severe hip ailments. This is particularly true if the strain occurs concurrently with a fracture. If your hip is unable to bear weight, it is critical that you get expert treatment from an orthopaedist.

Causes of Hip Flexor Strain

Causes of Hip Flexor Strain

If your hips have been feeling tight lately, odds are you have a hip flexor strain. This is a common injury in people who are walking, run or playing tennis. It’s also very likely that you overstretched your hip flexors by sitting incorrectly or sleeping in an awkward position. In fact, these two things can often cause the same effects!

Hip flexor strain develops as a result of excessive usage of the hip flexor muscles and tendons. Muscles and tendons become inflamed, uncomfortable, and painful as a consequence. Certain individuals are predisposed to hip flexor strain. These include the following:

  1. Cyclists
  2. Dancers
  3. Martial artists
  4. Kickers on a football team
  5. Soccer players
  6. Step aerobics participants

Hip flexor strain is also more likely to occur in athletes who jump or run while executing high knee kicks. You’re also more prone to suffer hip flexor strain if you do deep stretching, such as pushing your leg backward.

The main cause of hip flexor strain is a repetitive activity. It’s not uncommon for athletes to sustain this injury in their groin or hip region because they are constantly using their groin muscles to kick, run or jump. It’s important to stretch your body after you exercise so you can keep your muscles and tendons healthy and pain-free.

And another cause of hip flexor strain is Osteoarthritis. This causes irritation and inflammation of the hip joint capsule. Hip flexor pain can be debilitating, particularly in athletes who play soccer or other sports that require quick bursts of activity.

Hip flexor strain can also be developed if there is inflammation in the joint capsule itself. The tightness becomes so severe that it causes overstretching of the muscles and tendons at the hip joint.

If you are experiencing severe pain in your groin or hip joint, make sure you see an orthopedic physician to determine the cause.

Signs and Symptoms of A Hip Flexor Strain

Symptoms of A Hip Flexor Strain

The primary sign of a hip flexor strain is discomfort in the front of the hip. However, the disease is linked with a number of other symptoms. These include the following:

  1. Pain that seems to strike abruptly
  2. Pain intensifies when you raise your thigh toward your chest
  3. When extending your hip muscles, you may experience pain.
  4. Hip or thigh muscle spasms
  5. At the front of your hip, there is tenderness to the touch.
  6. Swelling or bruises around the hip or thigh

This pain may be felt when running or walking.

A lot of people who have a hip flexor strain experience pain during typical day-to-day activities. These activities that may cause pain include walking, climbing stairs, or sitting for long periods of time.

The pain associated with this condition is intense. It usually becomes more intense when you are moving the leg around. If you are not careful, it can get worse. If your symptoms are severe, you should see your doctor immediately.

Hip Flexor Tendonitis

Hip Flexor Tendonitis

Hip Flexor Tendonitis is a condition of inflammation and irritation of the hip flexor tendon over the front of the hip joint. It can affect various sports activities, such as cycling, golfing, soccer, and running. These symptoms include aching muscles, a burning sensation in the thigh area from extended use of the joint, along mild hip pain that is not aggravated by walking or standing.

Hip tendonitis is an inflammatory condition affecting any of the hip tendons, which are strong cords that connect muscles to bone. As with strains, hip tendonitis is often caused by excessive usage. Exercises such as high-intensity interval training (HIIT) and other exercises that require a lot of kicking, squatting, and leaping may potentially cause tendon irritation.

Hip flexor tendonitis is very common among athletes because of the intensity of exercises. There are two types of hip flexor tendinitis, “Acute” and “Chronic.”

Acute hip flexor tendonitis is defined as pain that lasts for less than six weeks. This form is typically characterized by tissue injury that occurs within 48 hours. Mild to moderate swelling may occur along with pain, weakness, and stiffness in the affected muscle group. This condition is most commonly caused by overuse of the hip flexor, most notably the iliopsoas muscle.

Chronic hip flexor tendonitis is defined as pain that has lasted for more than six weeks. This form of tendonitis is typically associated with runner’s knee, ulnar collateral ligament (UCL) damage, or overuse of the gluteus maximus muscle. This condition typically causes pain in the side of the hip area, thigh, groin area, and lower back pain.

Causes of Hip Flexor Tendonitis

There are many different types of tendonitis injuries, but one of the most commonly experienced is hip flexor tendonitis. What does this condition actually do? And how does it come about? Well, for starters, it is not an actual inflammation of any muscle or tendon in the hips. It is a repetitive use injury that may happen when someone overuses their hip flexors at work or home by performing repeated squats or lifts with their legs.

And here is the list of causes of Hip Flexor Tendonitis:

  1. Direct trauma to the hip
  2. Overuse of the hip flexors
  3. Bad posture or walking habits
  4. Rheumatoid arthritis, osteoarthritis, or gout

The hip flexor muscles are a group of muscles at the front of the thigh that straightens the knees by pulling the thigh upwards, so it is horizontal with the torso. The hip flexors consist of three separate muscles: psoas major, iliacus, and rectus femoris. The psoas major aids in lifting the leg for walking, running, and jumping. Hip muscles may also spasm due to a problem with the spinal discs or a herniated disc which puts pressure on their nerve roots.

Signs and Symptoms of Hip Flexor Tendonitis

Hip flexor tendonitis is a condition where the tendons of your hip flexor muscles become inflamed and sore. This can be due to a number of different things, including high-intensity training, overuse, or even sleeping on the stomach. The symptoms include pain in one or both hips as well as stiffness in the morning. If you have hip flexor tendonitis, it is important to take steps to prevent further damage and speed up recovery time, such as taking a break from exercising or wearing a knee strap at night.

And some of the following expressions:

  1. Hip, back, or leg pain
  2. Pain that builds gradually over time
  3. Stiffness
  4. Inflammation and swelling
  5. Around the tendon, there is warmth and redness.
  6. Knots seen around the tendon

Iliopsoas Syndrome (Psoas Syndrome)

The iliopsoas muscles are a pair of muscles situated near the front of the inner hip. They are the psoas and iliacus. The psoas muscle is situated in the lumbar (lower) portion of the spine and extends into the pelvis and femur. The iliopsoas muscles are the main hip flexors, contracting to lift the knee off the ground. Because the psoas muscle is also linked to the spine, it aids in lumbar spine movement and affects the curvature of the spine.

The most common injury to the iliopsoas is a tear in one of the tendons (tough bands of tissue that connect muscles to bones). Iliopsoas syndrome can be traumatic or result from repetitive strain. The symptoms of iliopsoas syndrome typically affect the hip and thigh. Pain typically occurs in the groin when running, walking, or when climbing stairs.

Pain may also be felt in the lower back and outer hip.

Iliopsoas syndrome, also known as psoas syndrome or iliopsoas tendonitis, is caused by an injury to the iliopsoas muscles. The most frequent symptom is lower back pain; however, discomfort may also develop in the hip, thigh, or leg. Due to the closeness of the two structures, the iliopsoas bursa, a fluid-filled sac situated on the inside of the hip that minimizes rubbing and friction, is also prone to inflammation. When this occurs, the inflamed bursae make movement difficult.

Everyone is vulnerable to iliopsoas syndrome, despite its rarity. Athletes, particularly those who regularly utilize their hip, are at a greater risk of acquiring the disease. Exercises such as running and plyometric leaping, in particular, may exacerbate inflammation and discomfort.

Causes of Iliopsoas Syndrome

Iliopsoas syndrome is a chronic pain condition where the iliopsoas muscles are involved. It is typically found on one side of the body but can affect both sides. The iliopsoas muscle is also known as the hip flexor muscle because it helps to flex your hips.

The cause can be due to overuse of this muscle in sports-related activities, pregnancy, or injury of the muscles around the hip joint cartilage.


  • Sudden iliopsoas muscle contraction or direct trauma
  • Excessive iliopsoas muscle usage
  • Arthritis rheumatoid

Signs and Symptoms of Iliopsoas Syndrome

Iliopsoas syndrome is a condition in which the iliopsoas muscle is obstructed or weakened. This can cause pain and difficulty withstanding. There are many cases where the signs of iliopsoas syndrome do not show initially, leaving people confused and worried about what’s going on with their bodies. This article will help you understand the signs of iliopsoas syndrome so that you know if it might be possible that you have this condition or if it might be something else affecting your body.

Signs and symptoms of iliopsoas syndrome may include:

  • Lower back, groin, or pelvic region pain
  • Radiating pain down the leg Pain when one or both legs are lifted
  • Ache while ascending stairs
  • Standing from a seated posture causes pain

Treatment and Recovery

Treatment Hip Flexor

Exercise and Stretching

Hip flexor exercises

While not everyone has the agility of Shakira’s hips, we may all benefit from strengthening the muscles that support this ball-and-socket joint. Not only are our hips responsible for the rocking dance movements we sometimes do, but they are also a critical region for runners, cyclists, and nonathletes alike.

Sitting for most of the day — something nearly everyone does — leads to tight hip flexors. Hip flexors that are too tight may result in lower back discomfort, hip pain, and damage.

Furthermore, hip issues do not end there. Hip replacements are increasing in popularity in the United States, according to the American Academy of Orthopaedic Surgeons. They are more prevalent among people in their early middle years.

To avoid breaking your body when busting a move — or just strolling down the street — here are nine excellent hip flexor exercises to maintain a strong and flexible hip region.

Hip flexor stretches

Seated butterfly stretch

This straightforward exercise stretches the inner thighs, hips, and lower back. And you can do it while seated!

  • Sit with your back straight and your abs engaged on the floor.
  • In front of you, bring the soles of your feet together. Allow your knees to bend outward.
  • As you draw your heels toward you, let your knees relax and move closer to the floor.
  • Take a deep breath and hold for 10 to 30 seconds in this position.

Pigeon pose

This famous yoga posture is considered advanced. Execute it just if you are comfortable with it. You are allowed to alter your posture.

  • Commence in the plank posture.
  • Lift your left foot off the floor and move it forward until your knee is adjacent to your left hand and your foot is close to your right. The precise location of your knees and toes is determined by your flexibility.
  • Slide your right leg back as much as possible while maintaining a square hip position, then drop yourself to the floor and onto your elbows, lowering your upper body as low as possible.
  • Maintain the stretch without allowing your chest to drop. Switch sides whenever you feel like you’ve received a decent stretch.


It’s amazing what you can do when lying down. I appreciate this Bridge stance!

  • Lie on your back, arms at your sides, feet flat on the floor, knees bent. Position your feet in such a way that your fingertips can touch your heels.
  • Squeeze your glutes and press your heels into the floor. Lift your hips off the floor toward the ceiling. Shimmy your shoulders as close together as possible beneath your torso.
  • Hold for a few seconds before returning to the starting position, and then repeat many times. Don’t forget to inhale and exhale!

It is important to understand that hip flexor issues are not only the result of tightness. Muscle weakness is another significant risk factor. When muscles are weak, they are more prone to tear. Additionally, other bodily structures must compensate for the deficiency.

Consider collaborating with a physical therapist to improve your hip muscles if they are weak. Additionally, physical therapists may suggest a regimen of sport-specific training. This is excellent for golfers, swimmers, and runners, as well as any athlete that needs not just hip preservation but also hip strength in order to stay competitive.


If you have hip flexor strain, it is critical to rest the afflicted muscles. One thing you may do is vary your routine to prevent overstretching the muscle. For instance, instead of riding a bicycle, you might try swimming.  Wearing support like a brace is very helpful but does not restrict movement. A poor posture may be the cause of your muscle strain, and if this is the case, you will need to correct it in order to prevent injury.  Check out the article on Posture for more information.

Home remedies

The majority of hip flexor strains are treatable at home without the need for prescription medicines or more invasive procedures. The following are some home treatments that may help alleviate the discomfort associated with hip flexor strain:

For 10 to 15-minute time increments, apply a cloth-covered ice pack to the afflicted region.

Beginning about 72 hours following the original injury, alternate ice packs, and wet heat treatments. Heat patches, moist heating pads, or a warm, wet washcloth are all examples of these. A hot shower may have a similar impact on muscular tension reduction.

Utilize an over-the-counter analgesic. Any of the following may be beneficial:

  • Acetaminophen (Tylenol)
  • Ibuprofen (Advil, Motrin)
  • Naproxen sodium (Aleve)

For the first 10 to 14 days after injury, rest and avoid activities that may cause your hip flexors to be overused (or longer if directed by your doctor).

  • Take the pressure off your hip flexors by using crutches for support instead of trying to walk on the injured leg
  • Avoid repetitive flexing exercises that can aggravate your injury. If you must do these exercises, modify them so that they are less strenuous. For example, try doing them standing rather than sitting or lying down.

In extreme situations

If the pressure on your hip flexors is severe enough to cause a significant muscle tear, your doctor may suggest visiting a physical therapist. Surgery to repair the damaged muscle may be recommended on occasion. However, this is a very uncommon event.


What is the outlook for hip flexor strain?

The outlook for a hip flexor strain can vary depending on the severity and treatment. For most people, recovery is relatively quick, and most patients will not require surgery. Hip flexor strains are typically treated with rest, ice, compression, and elevation (RICE).

There are different levels of severity of a hip flexor strain:

Grade 1: Tissue injury without major muscle tear, In this case, it is recommended to avoid any weight-bearing activities or excessive stretching exercises for two weeks.

Grade 2: Tear of the muscle belly (large muscle) or tendinous tissue -It is recommended to avoid all weight-bearing activities for at least two weeks.

Grade 3: Tear of muscle tendon and bone -It is recommended to avoid ALL weight-bearing activities for at least four weeks.

If the hip flexor strain was caused by falling on the front of the hip, then surgery will be required in almost every case. The goal of surgery is to repair any torn soft tissues and prevent future injuries from occurring.

How do I stop my hip flexor from hurting when I walk?

This varies from person to person. Some people experience hip flexor pain and tightness when walking, so they modify their gait and avoid jogging or running. Some people continue to walk despite experiencing pain because it is still a good form of exercise and offers cardioprotective benefits.

That being said, there are some stretches that you can do to alleviate the pain during your walks that will not only help you feel better but could even save your life if you have a heart attack.

The best stretches for hip flexor pain when walking are the quadriceps stretch, psoas stretch, and seated piriformis stretch.

When doing these stretches for hip pain while walking, you want to do each of them separately with a good warm-up, starting off with the quadriceps stretch because it’s important to get proper dynamic flexibility before doing any static stretching. Dynamic flexibility is where you perform movements that mimic the activity you intend on doing.

How do you treat a sore hip flexor?

Do a few sets of the above stretches after your regular warm-up and before an activity that stresses your hip flexors, such as a jog. Doing this will help strengthen the muscles and decrease nerve irritation.

Try icing the area if you have initial pain to help decrease inflammation and if it doesn’t get better or isn’t gone after a few days, see a doctor rule out joint problems.

Where do you feel hip flexor pain?

The hip flexor muscles attach along the front and back of the thigh to the pelvis and femur. Pain can be felt in either muscle group, although they are usually weak simultaneously. The quadriceps (also known as the thigh muscle) is responsible for extending the knee and hip, and it is a large, well-developed muscle that is often overstretched during running. The psoas (also known as the ‘tailbone’) attaches at L5/S1 and attaches down to the spine. The iliac connects to the lesser trochanter of the femur, which is located on the outside of the hip.

The pain that is felt in these muscles can be caused by repetitive motions, tightness, or weakness. The pain can be felt differently based on the form of exercise being performed. Individuals may feel tenderness when performing squats, lunges, deadlifts, or any exercise involving forward bending at the hips. Running and cycling are activities that people report feeling this type of pain.

How do you treat a sore hip flexor?

You can treat it by doing stretches. You can also do some warm-ups before stretching.

Is walking good for hip flexor strain?

Walking is good for hip flexor strain – slowly walk, clucking your head down, and putting your hands on your hips. Try doing this ten times, two or three times a day. This will help stretch the muscles relieving the pain.

How do I stop my hip from hurting when I walk?

If you are experiencing hip pain when walking, sit down for some rest.

A doctor would then examine your hamstring, psoas, and hips/pelvis to see if there is any muscle strain.

This may be due to the frequent use of foot strikes for running. If some muscles are tender, then try to strengthen them by doing some exercises or stretches.

Should you stretch a pulled hip flexor?

Yes, you should always stretch the muscle that is pulled.

When you are trying to heal your injury, rest is very important, but stretching is also very important.

It will help lengthen the muscles, which are tight during the healing process, so you avoid re-injuring yourself while running or playing sport.

Should I stretch my hip flexors before or after running?

You should stretch them after running because it helps to loosen them up.

How do you treat a pulled hip flexor without surgery?

You can treat a pulled hip flexor without surgery by resting, applying ice, and taking anti-inflammatory medication. You should then begin rehabilitation exercises that strengthen the muscles around your hip. These exercises will involve leg raises while lying on your back, assisted standing up from a sitting position, and leg raises while lying on your side.

Are squats good for hip flexors?

Squats are good for the hip flexors, but they are also good for the quads, hamstrings, calves, and glutes.

How should I sleep with hip flexor pain?

You should sleep on your side with the hip flexor away from you.

If you are having pain with sleeping, then elevating the hips with a few pillows is good, but not when you are lying down. This can be done when sitting or standing with your feet planted firmly on the floor.

Steven Ta
Steven Ta
I am a professional photographer and shoe-lover. With a deep-rooted passion for all things footwear and years of hands-on experience, I am your go-to guide in the awesome world of shoes
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